Hip or knee replacement (inpatient stay)
Facility: Merit Health River Region
Billing Code: 470 (MS-DRG)
- CPT Billing Code: 470
- Insurance Median: $14,039
- Cash Discount Price: Unavailable
- vs. Medicare Baseline: 1.00x Medicare
Average discount available for prompt cash payment at this facility.
Median negotiated contract rate across all mapped commercial carriers.
Standard federal government reimbursement rate for this code.
Visual Cost Comparison vs. Medicare
Understanding this gauge: We use the federal Medicare rate of $14,044.15 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.
Out-of-Pocket Cost Estimator
Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.
Commercial Insurance Negotiated Rates
Negotiated contract ranges established by major commercial carriers at this facility.
| Carrier / Plan Group | Contract Rate Range | vs. Medicare Reference |
|---|---|---|
| Ms Dept Of Rehabilitation Services | $1,979 | 14% |
| First Choice | $1,980 - $21,552 | 14% |
| Medicare (plans) | $13,698 | 98% |
| Node Magnolia Mcr Adv | $13,698 | 98% |
| UnitedHealthcare | $13,698 - $32,969 | 98% |
| Node Devoted Health Mcr Adv | $13,971 | 99% |
| Node First Choice American Health Of Ms Mcr Adv | $13,971 | 99% |
| Node Molina Mcr Adv | $13,971 | 99% |
| Node Peoples Health Mcr Adv | $13,971 | 99% |
| Aetna | $14,108 - $22,331 | 100% |
| Node First Choice Wellcare Mcr Adv | $14,221 | 101% |
| Node Va | $14,221 | 101% |
| Node Windsor Mcr Adv | $14,381 | 102% |
| First Choice Mpcn Standard | $15,181 | 108% |
| Node Healthy Mississippi Mcr Adv | $15,336 | 109% |
| Node Seven Corners | $19,151 | 136% |
| Node Us Dept Of Labor | $20,265 | 144% |
| Molina Exchange | $20,779 | 148% |
| Advanced Health Systems | $21,218 | 151% |
| Blue Cross Blue Shield | $23,322 | 166% |
| Magnolia Exchange | $24,399 | 174% |
| Ms Work Comp | $26,050 | 185% |
| Vantage Commercial | $27,884 | 199% |